Sexual Dysfunction in Lung Cancer Patients: A Need for Awareness

Many lung cancer patients experience difficulties with sexual expression and intimacy, a topic that has long been ignored by doctors and researchers, experts said at the Fourth European Lung Cancer Conference (ELCC), in Geneva, Switzerland.

"It's time that doctors and scientists paid more attention to this important issue," said Stephane Droupy, MD, PhD, from the University Hospital of Nimes, France, speaking at a special session on sexual dysfunction after lung cancer treatment at ELCC. He was joined by his colleague Luca Incrocci, MD, PhD, a radiation oncologist and sexologist from Erasmus Medical Center, Rotterdam, The Netherlands.

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Researchers have estimated that sexual dysfunction affects 40% to 100% of patients who undergo cancer treatment. Studies have shown that these problems can persist, rather than improve, as time passes.

However, much of the information gathered so far relates to breast, gynecologic, or prostate cancers. Much less is known about this adverse effect with other cancers, including lung cancer.

At the ELCC multidisciplinary interactive session on sexuality and cancer, Droupy and Incrocci discussed how to evaluate sexual function and how to treat sexual side effects after lung cancer therapy.

"We still have to do a lot of work on the awareness of sexual problems after cancer, and lung cancer in particular, and we hope that our session at ELCC will help begin the discussion about how best to help this group of patients," Droupy said.

The emotional and physical consequences of lung cancer, as well as the impact of treatments, can affect sexuality, he said.

For example, patients often experience a loss of libido when they learn they have cancer. Feelings of grief and depression can also diminish desire. The physical changes that result from cancer and the impact of treatments such as surgery, chemotherapy, and radiotherapy can also have negative impacts on sexual expression.

In the case of lung cancer, some of these problems can be particularly challenging. "Unlike other cancers, where survival is improving, lung cancer management often focuses on short-term quality of life improvement and palliative care. Sexuality is then even more difficult to protect or reconstruct in a short period of time when all efforts are made to stay alive,” Droupy explained. In this context, it is very important for patients and oncologists to seek help from health care professionals who specialize in sexual health.

Another important step is for clinicians and patients to have open and honest discussions about what the patient is going through, said Incrocci. "We know that sexuality is important for quality of life and marital relationships, yet health care professionals frequently avoid taking the sexual history of a cancer patient.”

"Of course, this is a difficult subject to deal with, for patients and for health care providers, but this should not stop us from doing what we can to improve the situation." said Incrocci. Their suggestions include begin discussing this issue at the beginning of treatment; be willing to provide solutions when sexual difficulties are reported; and organize specialized help in parallel with managing cancer, such as pharmacotherapy and sex therapy.

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